Assessment of pathological response to neoadjuvant chemotherapy in patients with breast carcinoma using Sataloff system

Background: Neoadjuvant chemotherapy is frequently administered to patients with breast carcinoma. Response to chemotherapeutic regime can be assessed clinically as well as by pathological examination of the breast tissue. It is essential to accurately categorize the patients with residual disease according to the standard guidelines for pathological evaluation of breast specimens after neoadjuvant chemotherapy. The present study was undertaken to assess the histomorphological changes in mastectomy specimens and axillary lymphatic nodes of patients receiving neoadjuvant chemotherapy, grade the pathological response using Sataloff system and to compare the clinical and pathological response after neoadjuvant chemotherapy. Methods: Present prospective study included a total of 31 patients with locally advanced breast carcinoma, diagnosed with infiltrating ductal carcinoma, not otherwise specified on biopsy specimen and subsequently treated with 2 to 6 cycles of neoadjuvant chemotherapy. Pathological response to neoadjuvant chemotherapy was assessed in breast and axillary lymphatic nodes according to Sataloff criteria. Results: Clinical response observed was complete (cCR) in four cases (12.9%), partial response (cPR) in 24 cases (77.4%), and no response (cNR) in three cases (9.7%). Based on tumor response, breast and lymph nodes were graded as pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR) in five (16.1%), 18 (58.1%) and eight (25.8%) cases respectively using Sataloff criteria. Ductal carcinoma in situ and lymphovascular invasion were seen in 11 (35.4%) and 16 cases (51.6%), respectively. Conclusion: The pathological assessment of tumor response remains the gold standard, as neither the clinical nor the radiological responses are sensitive predictors of tumor response after treatment. However pathological examination is quite challenging and demands sufficient experience along with detailed clinical and radiological data of pre- and postoperative neoadjuvant chemotherapy for precise response evaluation.

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Assessment of Pathological Response of Breast Carcinoma in Modified Radical Mastectomy Specimens after Neoadjuvant Chemotherapy

International Journal of Breast Cancer ◽

10.1155/2015/536145 ◽

2015 ◽

Vol 2015 ◽

pp. 1-8 ◽

Cited By ~ 4

Author(s):

Dhanya Vasudevan ◽

P. S. Jayalakshmy ◽

Suresh Kumar ◽

Siji Mathew

Keyword(s):

Breast Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Lymph Nodes ◽

Tumor Response ◽

Ductal Carcinoma ◽

Locally Advanced ◽

Radical Mastectomy ◽

Tumor Characteristics ◽

Modified Radical Mastectomy ◽

Tumor Bed

Aim. Paclitaxel based neoadjuvant chemotherapy regimen (NAT) in the setting of locally advanced breast cancer (LABC) can render inoperable tumor (T4, N2/N3) resectable. The aim of this study was to assess the status of carcinoma in the breast and lymph nodes after paclitaxel based NAT in order to find out the patient and the tumor characteristics that correspond to the pathological responses which could be used as a surrogate biomarker to assess the treatment response.Materials and Methods. Clinical and tumor characteristics of patients with breast carcinoma (n=48) were assessed preoperatively. These patients were subjected to modified radical mastectomy after 3 courses of paclitaxel based NAT regimen. The pathological responses of the tumor in the breast and the lymph nodes were studied by using Chevallier’s system which graded the responses into pathological complete response (pCR), pathological partial response (pPR), and pathological no response (pNR).Results. Our studies showed a pCR of 27.1% and a pPR of 70.9% . Clinically small sized tumors (2–5 cms) and Bloom Richardson’s grade 1 tumors showed a pCR. Mean age at presentation was 50.58 yrs. 79.2% of cases were invasive ductal carcinoma NOS; only 2.1% were invasive lobular carcinoma, their response to NAT being the same. There was no downgrading of the tumor grades after NAT. Ductal carcinoma in situ and lymphovascular invasion were found to be resistant to chemotherapy. The histopathological changes noted in the lymph nodes were similar to that found in the tumor bed.Discussion and Conclusion. From our study we conclude that histopathological examination of the tumor bed is the gold standard for assessing the chemotherapeutic tumor response. As previous studies have shown pCR can be used as a surrogate biomarker to assess the tumor response.

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Exploratory Analysis of 18F-3’-deoxy-3’-fluorothymidine (18F-FLT) PET/CT-Based Radiomics for the Early Evaluation of Response to Neoadjuvant Chemotherapy in Patients With Locally Advanced Breast Cancer

Frontiers in Oncology ◽

10.3389/fonc.2021.601053 ◽

2021 ◽

Vol 11 ◽

Author(s):

Lorenzo Fantini ◽

Maria Luisa Belli ◽

Irene Azzali ◽

Emiliano Loi ◽

Andrea Bettinelli ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Tumor Response ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Pathological Response ◽

Textural Features ◽

Flt Pet ◽

Pet Ct ◽

Response To Neoadjuvant Chemotherapy

PurposeThe objective of this study was to evaluate a set of radiomics-based advanced textural features extracted from 18F-FLT-PET/CT images to predict tumor response to neoadjuvant chemotherapy (NCT) in patients with locally advanced breast cancer (BC).Materials and MethodsPatients with operable (T2-T3, N0-N2, M0) or locally advanced (T4, N0-N2, M0) BC were enrolled. All patients underwent chemotherapy (six cycles every 3 weeks). Surgery was performed within 4 weeks of the end of NCT. The MD Anderson Residual Cancer Burden calculator was used to evaluate the pathological response. 18F-FLT-PET/CT was performed 2 weeks before the start of NCT and approximately 3 weeks after the first cycle. The evaluation of PET response was based on EORTC criteria. Standard uptake value (SUV) statistics (SUVmax, SUVpeak, SUVmean), together with 148 textural features, were extracted from each lesion. Indices that are robust against contour variability (ICC test) were used as independent variables to logistically model tumor response. LASSO analysis was used for variable selection.ResultsTwenty patients were included in the study. Lesions from 15 patients were evaluable and analyzed: 9 with pathological complete response (pCR) and 6 with pathological partial response (pPR). Concordance between PET response and histological examination was found in 13/15 patients. LASSO logistic modelling identified a combination of SUVmax and the textural feature index IVH_VolumeIntFract_90 as the most useful to classify PET response, and a combination of PET response, ID range, and ID_Coefficient of Variation as the most useful to classify pathological response.ConclusionsOur study suggests the potential usefulness of FLT-PET for early monitoring of response to NCT. A model based on PET radiomic characteristics could have good discriminatory capacity of early response before the end of treatment.

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Locally advanced breast carcinoma: computer assisted semiquantitative analysis of color Doppler ultrasonography in the evaluation of tumor response to neoadjuvant chemotherapy (work in progress).

Journal of Ultrasound in Medicine ◽

10.7863/jum.2000.19.9.601 ◽

2000 ◽

Vol 19 (9) ◽

pp. 601-607 ◽

Cited By ~ 18

Author(s):

S Huber ◽

M Medl ◽

T Helbich ◽

S Taucher ◽

T Wagner ◽

...

Keyword(s):

Breast Carcinoma ◽

Neoadjuvant Chemotherapy ◽

Doppler Ultrasonography ◽

Tumor Response ◽

Color Doppler ◽

Locally Advanced ◽

Color Doppler Ultrasonography ◽

Computer Assisted ◽

Semiquantitative Analysis ◽

Response To Neoadjuvant Chemotherapy

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Thermal tomography for monitoring tumor response to neoadjuvant chemotherapy in women with locally advanced breast cancer

Oncotarget ◽

10.18632/oncotarget.16569 ◽

2017 ◽

Vol 8 (40) ◽

pp. 68974-68983

Author(s):

Qi Wu ◽

Juanjuan Li ◽

Si Sun ◽

Xiaoli Yao ◽

Shan Zhu ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Advanced Breast Cancer ◽

Tumor Response ◽

Locally Advanced Breast Cancer ◽

Locally Advanced ◽

Advanced Breast ◽

Thermal Tomography ◽

Response To Neoadjuvant Chemotherapy

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Texture analysis versus conventional MRI prognostic factors in predicting tumor response to neoadjuvant chemotherapy in patients with locally advanced cancer of the uterine cervix

La radiologia medica ◽

10.1007/s11547-019-01055-3 ◽

2019 ◽

Vol 124 (10) ◽

pp. 955-964 ◽

Cited By ~ 1

Author(s):

Maria Ciolina ◽

Valeria Vinci ◽

Laura Villani ◽

Silvia Gigli ◽

Matteo Saldari ◽

...

Keyword(s):

Prognostic Factors ◽

Neoadjuvant Chemotherapy ◽

Texture Analysis ◽

Advanced Cancer ◽

Uterine Cervix ◽

Tumor Response ◽

Locally Advanced ◽

Conventional Mri ◽

Locally Advanced Cancer ◽

Response To Neoadjuvant Chemotherapy

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Biomarkers detected by proteomic analysis predicts breast cancer response to neoadjuvant chemotherapy

Journal of Clinical Oncology ◽

10.1200/jco.2006.24.18_suppl.669 ◽

2006 ◽

Vol 24 (18_suppl) ◽

pp. 669-669

Author(s):

D. Shen ◽

J. He ◽

J. Gornbein ◽

Z. Chen ◽

K. F. Faull ◽

...

Keyword(s):

Breast Cancer ◽

Neoadjuvant Chemotherapy ◽

Proteomic Analysis ◽

Tumor Response ◽

Classification Tree ◽

Objective Assessment ◽

Locally Advanced ◽

Poor Responders ◽

Protein Biomarkers ◽

Response To Neoadjuvant Chemotherapy

669 Background: Neoadjuvant chemotherapy provides an excellent opportunity for objective assessment of treatment-induced tumor response and for studying biomarkers characteristic of therapy-induced tumor responses. Methods: Proteomic analysis of T3/T4 breast cancer was performed in patients with locally advanced breast cancer in a phase II clinical trial. The breast cancer specimen was obtained before and after four cycles of Taxotere/Carboplatin/±Herceptin treatment. Two proteomic approaches, SELDI mass spectrometry and Clontech Ab Microarray 500, were used to screen for protein biomarkers that predict response of breast cancer to chemotherapy. Results: Five tumors with pathologically complete response (pCR) and 29 tumors with various amounts of residual tumors (Non-pCR) were analyzed by SELDI-TOF using the NP 20 chip. The normalized mass signals were compared between pCR vs Non-pCR at each aligned location by Wilcoxon rank sum test. Statistically significant differences were found at 22 m/z locations using a liberal p <0.20 criterion. The best univariate predictor occurred at m/z 14960 (p=0.004), which correctly classified 5/5 pCR spectra (100%) and 24/29 Non-pCR spectra (83%). A multivariate classification tree developed using m/z 14960 and m/z 12138 intensities correctly classified all 34 spectra. Ab microarray analysis was performed on five pCR tumors and in five tumors with the largest residual cancer. The Internal Normalization Ratio (INR) was calculated and used to compare the difference of protein expression between the two groups. Eight differentially expressed protein biomarkers were selected with the criteria of a statistically significant (Student t, p<0.05) expression change of <0.77 or >1.3 fold. Three proteins (Tat-SF1, PYK2 and PTP1B) were higher, and five (E2F2, IL1b, FEN1, CDC37 and ACM1) were lower in tumors with pCR. The unsupervised hierarchical clustering of the 10 samples by these eight proteins completely separated the pCR tumors from the poor responders. Conclusions: Our study suggests that bothSELDImass spectrometry and antibody microarray may be used to predict the tumor response to neoadjuvant chemotherapy. Proteomic analysis may be useful in developing tailored chemotherapy for breast cancer. [Table: see text]

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